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Gulf Coast Urology, L.L.C.

Details

Name: Gulf Coast Urology, L.L.C.
Jurisdiction: Alabama
Legal type: Domestic Limited Liability Company
Status: Exists
Date of registration: 15 Nov 2004 (20 years ago)
Entity Number: 000-457-533
Register Number: 000457533
County: Baldwin
Place of Formation: Baldwin County
Principal Address: FOLEY, AL
Registered Office Street Address: 109 E FERNFOLEY, AL 36535
Registered Office Street Address ZIP Code: 36535

Activities PROVIDE GENERAL/PEDIATRIC UROLOGICAL CARE (MEDICAL/SURGICAL)

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1194928200 2007-06-06 2019-06-06 102 S GREENTREE LANE, FOLEY, AL, 365354509, US 102 S GREENTREE LANE, FOLEY, AL, 365354509, US

Contacts
Phone +1 251-943-8761
Fax 2519478761

Authorized person
Name MICHAEL G WATERS
Role PHYSICIAN/OWNER
Phone 2519438761

Taxonomy
Taxonomy Code 208800000X - Urology Physician
License Number DO879
State AL
Is Primary Yes

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
GULF COAST UROLOGY, L.L.C. 401(K) PROFIT SHARING PLAN 2017 134286511 2018-10-10 GULF COAST UROLOGY, L.L.C. 3
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2005-01-01
Business code 621111
Sponsor’s telephone number 2519438761
Plan sponsor’s address 102 SOUTH GREENTREE LANE, FOLEY, AL, 36535

Signature of
Role Plan administrator
Date 2018-10-10
Name of individual signing MICHAEL WATERS
Role Employer/plan sponsor
Date 2018-10-10
Name of individual signing MICHAEL WATERS
GULF COAST UROLOGY, L.L.C. 401(K) PROFIT SHARING PLAN 2017 134286511 2018-10-10 GULF COAST UROLOGY, L.L.C. 3
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2005-01-01
Business code 621111
Sponsor’s telephone number 2519438761
Plan sponsor’s address 102 SOUTH GREENTREE LANE, FOLEY, AL, 36535

Signature of
Role Plan administrator
Date 2018-10-10
Name of individual signing MICHAEL WATERS
Role Employer/plan sponsor
Date 2018-10-10
Name of individual signing MICHAEL WATERS
GULF COAST UROLOGY, L.L.C. 401(K) PROFIT SHARING PLAN 2016 134286511 2017-10-07 GULF COAST UROLOGY, L.L.C. 3
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2005-01-01
Business code 621111
Sponsor’s telephone number 2519438761
Plan sponsor’s address 102 SOUTH GREENTREE LANE, FOLEY, AL, 36535

Signature of
Role Plan administrator
Date 2017-10-06
Name of individual signing MICHAEL WATERS
Role Employer/plan sponsor
Date 2017-10-06
Name of individual signing MICHAEL WATERS
GULF COAST UROLOGY, L.L.C. 401(K) PROFIT SHARING PLAN 2015 134286511 2017-06-01 GULF COAST UROLOGY, L.L.C. 3
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2005-01-01
Business code 621111
Sponsor’s telephone number 2519438761
Plan sponsor’s address 102 SOUTH GREENTREE LANE, FOLEY, AL, 36535

Signature of
Role Plan administrator
Date 2017-06-01
Name of individual signing MICHAEL WATERS
Role Employer/plan sponsor
Date 2017-06-01
Name of individual signing MICHAEL WATERS
GULF COAST UROLOGY, L.L.C. 401(K) PROFIT SHARING PLAN 2014 134286511 2017-06-01 GULF COAST UROLOGY, L.L.C. 3
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2005-01-01
Business code 621111
Sponsor’s telephone number 2519438761
Plan sponsor’s address 102 SOUTH GREENTREE LANE, FOLEY, AL, 36535

Signature of
Role Plan administrator
Date 2017-06-01
Name of individual signing MICHAEL WATERS
Role Employer/plan sponsor
Date 2017-06-01
Name of individual signing MICHAEL WATERS
GULF COAST UROLOGY, L.L.C. 401(K) PROFIT SHARING PLAN 2013 134286511 2014-10-15 GULF COAST UROLOGY, L.L.C. 3
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2005-01-01
Business code 621111
Sponsor’s telephone number 2519438761
Plan sponsor’s address 102 S. GREENTREE LANE, FOLEY, AL, 36535

Signature of
Role Plan administrator
Date 2014-10-15
Name of individual signing MICHELE MARIE WATERS
GULF COAST UROLOGY, L.L.C. 401(K) PROFIT SHARING PLAN 2012 134286511 2013-10-15 GULF COAST UROLOGY, L.L.C. 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2005-01-01
Business code 621111
Sponsor’s telephone number 2519438761
Plan sponsor’s address 102 S. GREENTREE LANE, FOLEY, AL, 36535

Signature of
Role Plan administrator
Date 2013-10-15
Name of individual signing MICHELE MARIE WATERS
GULF COAST UROLOGY, L.L.C. 401(K) PROFIT SHARING PLAN 2011 134286511 2012-10-12 GULF COAST UROLOGY, L.L.C. 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2005-01-01
Business code 621111
Sponsor’s telephone number 2519438761
Plan sponsor’s address 102 S. GREENTREE LANE, FOLEY, AL, 36535

Plan administrator’s name and address
Administrator’s EIN 134286511
Plan administrator’s name GULF COAST UROLOGY, L.L.C.
Plan administrator’s address 102 S. GREENTREE LANE, FOLEY, AL, 36535
Administrator’s telephone number 2519438761

Signature of
Role Plan administrator
Date 2012-10-12
Name of individual signing MICHELE MARIE WATERS
Role Employer/plan sponsor
Date 2012-10-12
Name of individual signing MICHELE MARIE WATERS
GULF COAST UROLOGY, L.L.C. 401(K) PROFIT SHARING PLAN 2010 134286511 2011-10-14 GULF COAST UROLOGY, L.L.C. 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2005-01-01
Business code 621111
Sponsor’s telephone number 2519438761
Plan sponsor’s address 102 S. GREENTREE LANE, FOLEY, AL, 36535

Plan administrator’s name and address
Administrator’s EIN 134286511
Plan administrator’s name GULF COAST UROLOGY, L.L.C.
Plan administrator’s address 102 S. GREENTREE LANE, FOLEY, AL, 36535
Administrator’s telephone number 2519438761

Signature of
Role Plan administrator
Date 2011-10-14
Name of individual signing MICHELE MARIE WATERS
Role Employer/plan sponsor
Date 2011-10-14
Name of individual signing MICHELE MARIE WATERS
GULF COAST UROLOGY, L.L.C. 401(K) PROFIT SHARING PLAN 2010 134286511 2011-10-12 GULF COAST UROLOGY, L.L.C. 5
Three-digit plan number (PN) 001
Effective date of plan 2005-01-01
Business code 621111
Sponsor’s telephone number 2519438761
Plan sponsor’s address 102 S. GREENTREE LANE, FOLEY, AL, 36535

Plan administrator’s name and address
Administrator’s EIN 134286511
Plan administrator’s name GULF COAST UROLOGY, L.L.C.
Plan administrator’s address 102 S. GREENTREE LANE, FOLEY, AL, 36535
Administrator’s telephone number 2519438761

Signature of
Role Plan administrator
Date 2011-10-12
Name of individual signing MICHELE MARIE WATERS
Role Employer/plan sponsor
Date 2011-10-12
Name of individual signing MICHELE MARIE WATERS

Agent

Name Role
WATERS, MICHAEL G Agent

Member

Name Role
WATERS, MICHAEL G Member

Related by officers

WATERS, MICHAEL G

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Date of last update: 13 Aug 2024

Sources: Alabama Secretary of State

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